Some types of glaucoma that occur in penetrating keratoplasty in patients who are aphakic are related to surgical technique. We have already shown that this can be predicted and that using a donor cornea larger than the recipient size is one means of helping to prevent some forms of very high acute glaucoma seen right after surgery. We propose to look at this in greater detail to ascertain all of those factors of the surgical technique that we can delineate that will help prevent this type of glaucoma. The direct corollary to this is the fact that present surgical technique is inadequate in providing a close match between the recipient opening and the donor tissue, both in regards to this iatrogenic glaucoma and astigmatism. We are currently interested in variations of current techniques and also new techniques that will result in a finer control of the size and type of cut that occurs with corneal surgery. We are also interested in variations in suturing that might produce less distortion in corneal surgery. Elevated intra-ocular pressure when sufficiently high can result in epithelial edema. This, however, is not necessarily correlated with the swelling of the corneal stroma. We propose to look at corneal thickness change as related to intraocular pressure. This should lead to a better understanding of the physiology of the corneal endothelium.